MUSCULOSKELETAL · Musculoskeletal is a general term which is deﬁnedas relating to musclesand bones of the skeleton. The musculoskeletal system comprises bones, joints, cartilage,

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MUSCULOSKELETAL

Khaleel Alyahya, PhD, MEd

RECOURSES

Gray’s Anatomy

By Richard Drake, Wayne Vogl & Adam Mitchell

Essential of Human Anatomy & Physiology

By Elaine Marieb and Suzanne Keller

Mosby’s Dictionary

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KENHUB

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Atlas of Human Anatomy

By Frank Netter

Khaleel Alyahya, PhD, MEd 3

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Introduction


▪ Musculoskeletal is a general term which is defined asrelating to muscles and bones of the skeleton.

▪ The musculoskeletal system comprises bones, joints,cartilage, bursae, tendons, muscles and ligaments.

▪ It is the system that moves the body and maintains its form.

▪ Study of this system consists of osteology (the study ofbones), arthrology (the study of joints), and myology (thestudy of muscles).

▪ The musculoskeletal system does not work in isolation.

▪ It is closely linked with many other systems in the body,including the nervous system, genitourinary system,circulatory system, immune system, respiratory system,digestive system and endocrine system.

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Structures


▪ The adult human body consists of 206 bones.

▪ Prior to birth, the skeleton is made up of flexible cartilage.

▪ As the body grows, ossification takes place as the cartilage isreplaced by hard deposits of calcium, phosphorus andcollagen, which make up the bones.

▪ In newborn babies the body has 270 bones but many of thesefuse as the child grows.

▪ The smallest bones are the ossicles in the middle ear and thelargest bones are the right and left femurs, or thigh bones.

▪ Around 30–40% of the body’s total weight is made up of thebones.

▪ There are certain differences in the bones of males andfemales, primarily in the pelvic region because of therequirement of the female pelvis to accommodate pregnancyand childbirth.

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Classifications


▪ The two main divisions of the bones of the body are called theaxial skeleton and the appendicular skeleton.

▪ The axial skeleton is made up of the skull, rib cage andvertebral column.

▪ The remainder of the skeleton, including the extremities, isknown as the appendicular skeleton.

▪ It is called appendicular because these bones are appendedor attached to the axial skeleton.

▪ Bones are classified into five types:

• Long bones (such as femur, tibia, humerus, radius).

• Short bones (such as the bones in the ankles and wrists).

• Flat bones (sternum, cranium, scapula, ribs).

• Irregular bones (vertebrae, hips, bones of the face).

• Sesamoid bones (round bone masses embedded in tendons,such as the patella).

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Functions


▪ To provide a framework to shape and support the body and aplace for tendons and muscles to attach

▪ To enable movement, by acting as levers in collaboration withmuscles and joints

▪ To provide protection for the body’s most vital and delicateorgans, the brain, heart and lungs amongst others

▪ To create blood cells by a process called haematopoiesis,this takes place in the bone marrow

▪ To store minerals such as calcium and iron

▪ To help regulate certain hormones including those thatassist with maintenance of blood sugar levels and depositionof fats.

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Types of Osseous Tissue


▪ There are two types of osseous tissue making up bones:

• Compact or hard bony tissue (also known as cortical tissue).

• Cancellous or spongy tissue.

▪ The difference lies in the denseness of the cells.

▪ Hard bone is made up of closely packed cells which have thincanals running through them for blood vessels to passthrough.

▪ This compact tissue is usually located on the outside ofbones and gives bones their characteristic hard, smooth, whiteappearance.

▪ Cancellous bone has spaces in between the cells, giving ita lattice-like appearance.

▪ This type of osseous tissue is generally found on the insideof bones, is highly vascular and generally houses the bonemarrow where haematopoiesis takes place.

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Composition


▪ In a long bone, the diaphysis or shaft, makes up most of thebone’s length and is composed of compact bone.

▪ The diaphysis is covered and protected by a fibrousconnective tissue membrane, the periosteum.

▪ Hundreds of connective tissue fibers, called perforating fibers,or Sharpey’s fibers, secure the periosteum to the underlyingbone.

▪ The epiphyses are the ends of long bones.

▪ Each epiphysis consists of a thin layer of compact boneenclosing an area filled with spongy bone.

▪ Instead of a periosteum, articular cartilage covers its externalsurface.

▪ In adult bones, there is a thin line of bony tissue spanning theepiphysis that looks a bit different from the rest of the bone inthat area. This is the epiphyseal line.

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Composition


▪ The inner bony surface of the shaft is covered by a delicateconnective tissue called endosteum.

▪ In infants, the cavity of the shaft, called the medullary cavity, isa storage area for red marrow, which produces blood cells.

▪ Children’s bones contain red marrow until the age of 6 or 7,when it is gradually replaced by yellow marrow, which storesadipose (fat) tissue.

▪ In adult bones, red marrow is confined to cavities in thespongy bone of the axial skeleton, the hip bones, and theepiphyses of long bones such as the humerus and femur.

▪ There are two categories of bone markings:

• Projections, or processes, which grow out from the bone surface,

• Depressions, or cavities, which are indentations in the bone.

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Long Bones


▪ Long bones include femur (the longest bone in thebody) and small bones in the fingers.

▪ Function to support the weight of the body and facilitatemovement.

▪ Located in the appendicular skeleton and include bonesin upper and lower limbs.

▪ Formed of:• A shaft (diaphysis): composed of compact bone.

• Two ends (epiphysis): composed of spongy bone.

• The region of contact between epiphysis & diaphysis is called:metaphysis

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Short Bones


▪ Located in the wrist and ankle joints,

▪ Short bones provide stability and some movement.

▪ Examples of short bones:• The carpals in the wrist

• The tarsals in the ankles

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Flat Bones


▪ There are flat bones in the skull, the thoracic cage andthe pelvis.

▪ The function of flat bones is to protect internal organssuch as the brain, heart, and pelvic organs.

▪ Flat bones can also provide large areas of attachmentfor muscles.

▪ Examples of flat bones:• occipital, parietal and frontal in skull.

• sternum and ribs in thoracic cage.

• ilium and pubis in pelvis.

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Irregular Bones


▪ Irregular bones vary in shape and structure andtherefore do not fit into any other category (flat, short,long, or sesamoid).

▪ They often have a fairly complex shape, which helpsprotect internal organs.

▪ For example, the vertebrae protect the spinal cord.

▪ Also the irregular bones of the pelvis (pubis, ilium, andischium) protect organs in the pelvic cavity.

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Sesamoid Bones


▪ Sesamoid bones are bones embedded in tendons.

▪ These small, round bones are commonly found in thetendons of the hands, knees, and feet.

▪ Sesamoid bones function is to protect tendons fromstress.

▪ The patella is an example of a sesamoid bone.

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Pathology & Diseases

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Curvature of Spine


▪ Kyphosis is an abnormal convex or posterior curvatureof the thoracic spine. It is also called hunchback orhumpback.

▪ Lordosis is an abnormal concave or anterior curvatureof the lumbar spine. It is also called a sway back.

▪ Scoliosis is a lateral S-shaped curvature of the spine.

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Fractures


▪ A fracture is a break or crack in a bone.

▪ Fractures are caused by trauma such as a faller motorvehicle accident, through overuse or repetitivemovements as may occur in athletes, or as a result ofa disease process such as osteoporosis that weakensthe bones.

▪ Fractures are classified by type and whether they areopen or closed.

▪ Open fracture: a fracture in which there is an openwound communicating with the fracture exposing theunderlying bone. There is an increased risk of infectionwith an open fracture.

▪ Closed fracture: the bone is broken but there is no openwound.

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Herniated Intervertebral

Disc


▪ Intervertebral discs are pillows of fibrocartilagenous tissue locatedbetween the vertebrae of the spine.

▪ Sometimes as a result of an acute injury to the spine or because ofdegenerative wear and tear to a disc, it splits or ruptures.

▪ When this happens, the inner gel-like substance (nucleus pulposus)leaks out into the spinal canal.

▪ This is called a herniation of the nucleus pulposus — or a herniateddisc.

▪ A herniated disc is often referred to as a slipped disc, but thisterminology is erroneous as a disc cannot actually slip.

▪ The most common site for a herniated disc is in the lumbar spineespecially at L4–L5.

▪ Symptoms will vary depending on the site and degree of theherniation but can include paraesthesia sciatica and back pain.

▪ Some patients will not experience any pain at all.

▪ Many cases will resolve spontaneously with bed rest, analgesicsand physiotherapy, but if the condition persists, more invasivetreatment such as discectomy or laminectomy may be required.

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Osteomalacia


▪ Osteomalacia is a softening of the bones due to a lackof vitamin D or a problem with the body’s ability tometabolize and absorb this vitamin.

▪ Adequate amounts of vitamin D are essential for thebody to be able to absorb calcium and phosphorous intothe bloodstream.

▪ Vitamin D deficiency may be caused by a lack in thediet, limited exposure to sunlight which producesvitamin D in the body or malabsorption by the intestines.

▪ Treatment involves vitamin D, calcium and phosphoroussupplements.

▪ In children, osteomalacia is called rickets.

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Osteoporosis


▪ Osteoporosis occurs when there is a decrease in bonedensity due to bones losing minerals, such as calcium,more quickly than the body can replace them.

▪ Bones become porous and brittle resulting in anincreased likelihood of fractures.

▪ While any bone can be affected by osteoporosis, themost common sites for osteoporotic fractures are thehip, spine, ribs, pelvis, wrist and upper arm.

▪ While it is most frequently seen in postmenopausalwomen due to decreased levels of oestrogen,osteoporosis can occur in younger women and in men.

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JOINTS

Introduction


▪ Joints are the location where two or more bones cometogether to create body movement or articulation.

▪ There are three types of joints classified according whetherthey move a lot, a little, or not at all:

• Fibrous

• Cartilaginous

• Synovial

▪ Also, Joints can be classified based on the number of bonesinvolved, and into complex and combination joints:

• Simple joint:

o two articulation surfaces (shoulder and hip joints)

• Compound joint:o three or more articulation surfaces (radiocarpal joint)

• Complex joint:

o two or more articulation surfaces and an articulardisc or meniscus (knee joint)

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Introduction


▪ Most joints are mobile, allowing the bones to move.

▪ Joints consist of the following:

• Cartilage

o This is a type of tissue that covers the surface of a bone at a joint.

o Cartilage helps reduce the friction of movement within a joint.

• Synovial membrane

o A tissue called the synovial membrane lines the joint and seals it into a joint capsule.

o The synovial membrane secretes a clear, sticky fluid (synovial fluid) around the joint tolubricate it.

• Synovial fluid

o A clear, sticky fluid secreted by the synovial membrane.

• Ligaments

o Strong ligaments (tough, elastic bands of connective tissue) surround the joint to givesupport and limit the joint's movement.

o Ligaments connect bones together.

• Tendons

o Tendons (another type of tough connective tissue) on each side of a joint attach to musclesthat control movement of the joint.

o Tendons connect muscles to bones.

• Bursae

o Fluid-filled sacs, called bursas, between bones, ligaments, or other nearby structures.

o They help cushion the friction in a joint.

• Meniscus

o This is a curved part of cartilage in the knees and other joints.

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Fibrous Joints


▪ Fibrous joints are fixed and unable to move because thickmembranous collagen fibers hold the bones together.

▪ This type of joint is found in the skull where the coronalsuture joins the frontal and parietal bones; the sagittal suturejoins the two parietal bones from the front to the back andthe lambdoid suture joins the parietal bones with the occipitalbone.

▪ Examples:

• Skull sutures: No movement

• Inferior tibiofibular joints: very Little movement,permanent joints.

• Gomphoses: Between teeth and their socket.

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Cartilaginous Joints


▪ Cartilaginous joints have cartilage between them.

▪ Although they allow movement, this is far more restrictedthan the movement of synovial joints.

▪ The joints of the vertebral column and the pelvis are examplesof this type of joint.

▪ Primary Cartilaginous

• The bones are united by a plate or a bar of hyaline cartilage.

• No movement, temporary joints.

• Example:

o Between the Epiphysis and Diaphysis of a growing bone.

o Between the First Rib and the Sternum (1st sternocostal joint).

▪ Secondary Cartilaginous

• The bones are united by a plate of fibrocartilage.

• Little movement, permanent joints.

• They are called Midline joints.

• Example:

o Joints between the Vertebral Bodies (intervertebral discs).

o Symphysis Pubis

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Synovial Joints


▪ Synovial joints permit the greatest range of movement.

▪ In between the bones are spaces covered with synovialmembrane, which fill with synovial fluid.

▪ This fluid lubricates and protects the bones as they move.

▪ The articular surfaces are covered by a thin layer of hyalinecartilage (articular cartilage).

▪ A joint cavity enclosed within the capsule.

▪ A thin vascular synovial membrane lining the inner surface ofthe capsule.

▪ A lubricating synovial fluid produced by synovial membranein the joint cavity.

▪ The fluid minimizes the friction between the articularsurfaces.

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Classifications ofSynovial Joints


▪ Synovial joints permit the greatest range of movement.

▪ According to the range of movement synovial joints areclassified into:

▪ Plane Synovial Joints

• The articulating surfaces are flat.

• The bones slide on one another, producing a glidingmovement.

• Examples:

o Intercarpal Joints

o Sternoclavicular joint

o Acromioclavicular joint

▪ Axial Synovial Joints

• Movements occur along an axes:

o Transverse axis: flexion & extension.

o Longitudinal axis: rotation.

o Antero-posterior axis: abduction & adduction.

• Axial joints are divided into:

o Uniaxial.

o Biaxial.

o Multi-axial or (polyaxial).29

UniaxialSynovial Joints


▪ Hinge joints

• Axis: transverse.

• Movements: flexion & extension.

• Example: elbow joint and ankle joint.

▪ Pivot joints

• Axis: longitudinal.

• Movements: rotation.

• Example: radio-ulnar and atlantoaxial joint.

o A joint in the upper part of the neck between the first andsecond cervical vertebrae; the atlas and axis

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BiaxialSynovial Joints


▪ Ellipsoid joints:

• An elliptical convex fits into an elliptical concave articularsurfaces.

• Axes: Transverse & anteroposterior.

• Movements: flexion & extension + abduction &adduction. BUT rotation is impossible.

• Example: Wrist joint.

▪ Saddle joints

• The articular surfaces are reciprocally concavoconvex.

• They resemble a saddle on a horse’s back.

• Movement:

o As ellipsoid joints (Flexion & extension + abduction &adduction) + a small range of rotation.

o Example: Carpometacarpal joint of the thumb.

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PolyaxialSynovial Joints


▪ Ball-and-Socket joints:

• A ball–shaped head of a bone fits into a socket-likeconcavity of another.

• Movements: Flexion & extension + abduction &adduction + medial & lateral rotation.

• Examples:

o Shoulder joint.

o Hip joint.

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Factors Effecting Stability of

Synovial Joints


▪ The shape of articular surfaces:

• The ball and socket shape of the Hip joint is a goodexamples of the importance of the shape of the bone, tomaintain joint stability.

• The shape of the bones forming the Knee joint hasnothing to do for stability.

▪ Strength of the ligaments:

• They prevent excessive movement in a joint.

▪ Tone of the surrounding muscles:

• In most joints, it is the major factor controlling stability.

• The short muscles around the shoulder joint (rotatorcuff) keeps the head of the humerus in the shallowglenoid cavity.

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Arthritis


▪ Arthritis is inflammation of a joint resulting in pain, swellingand alteration to structure and function.

▪ There are several types of arthritis with different aetiologies

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Osteoarthritis


▪ Osteoarthritis is the most common form of joint inflammation(arthritis).

▪ It stems from heavy use of articular joints over the course ofmany years, which can result in the wearing away of articularcartilage.

▪ The changes which occur are irreversible and degenerative.This results in the decreased effectiveness of articularcartilage as a shock absorber and lubricated surface, as wellas the roughened edges causing further damage.

▪ As a result of this degeneration, repeated friction can causesymptoms of joint pain, stiffness and discomfort.

▪ This condition usually affects joints that support full bodyweight, such as the hips and the knees.

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Bursitis


▪ Bursitis is inflammation of a bursa (a fibrous fluid-filled sacbetween a tendon and bone).

▪ Normally, the bursa provides a slippery surface that assistsmovement and reduces friction.

▪ When a bursa becomes inflamed it results in joint pain,stiffness and swelling around the affected joint.

▪ Bursitis is caused by chronic overuse, trauma and infection.The most commonly affected joints are the shoulder, elbow,knee and hip.

▪ Treatment consists of administering NSAIDs such asibuprofen, physiotherapy and rest as required.

▪ In some cases an injection of a corticosteroid into the joint isrequired.

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Dislocation


▪ A dislocation (also called a luxation) is the displacement oftwo bones from their position where they articulate in a joint.

▪ It usually occurs as the result of trauma.

▪ Ligaments in the joint are usually injured as well.

▪ A subluxation is a partial dislocation.

▪ An x-ray is required to identify if a fracture has also occurred.

▪ Any dislocation needs to be reduced urgently to preventcomplications such as ischaemia.

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Sprain


▪ A sprain occurs when a ligament is overstretched or torndue to trauma to the joint.

▪ The most common site affected is the ankle.

▪ There is no fracture or dislocation present.

▪ It can result in pain, swelling, joint instability and loss offunction.

▪ Rest, application of ice and a compression bandage areeffective treatments.

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MUSCLES

Introduction


▪ There are more than 650 muscles in the human body, whichtogether compose around half of the body weight of theaverage human.

▪ Muscle tissue is made up of cells that are called fibres.

▪ Depending on their purpose, the size and shape of the fibresdiffers.

▪ The fibres are surrounded by connective tissue and areenclosed in fascia, a type of strong connective tissue.

▪ As the muscle fibres contract and relax, they producemovement in the body.

▪ Many body movements are a result of several musclesworking collaboratively.

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Structures


▪ Muscles are often grouped in pairs, where a contraction ofone muscle moves a bone in a direction, and a contraction ofthe other muscle moves the bone in the opposite direction.

▪ The biceps and triceps muscles of the upper arm are a goodexample of this mechanism.

▪ When the central nervous system instructs the biceps muscleto contract, a corresponding impulse relaxes the tricepsmuscle, and vice versa.

▪ Occurring at the same time, these impulses allow formovement in both directions.

▪ Muscles can be attached to bones, to skin or to other musclesby tendons and aponeuroses.

▪ Tendons are thick fibrous bands of tissue, whereasaponeuroses are more like flat ribbons, having fewer bloodvessels and nerves than tendons.

▪ The body regions with aponeuroses are in the ventralabdominal region, the dorsal lumbar region, and in the palm ofthe hand.

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Skeletal Muscle


▪ Skeletal muscle attaches to bones by tendons across aconnecting joint, which allows the muscles to pull on bonesand create movement.

▪ Skeletal muscle is striated in appearance; that is, the cellfibres have alternating light and dark bands (known asstriations).

▪ Skeletal muscles are under the conscious control of the body,in other words, they are voluntary muscles.

▪ These muscles hold the skeleton together, give the bodyshape, and help it with everyday movements by contracting ortightening.

▪ Skeletal muscles vary considerably in size, shape andarrangement of fibres.

▪ The smallest muscles in the body are found in the inner earand the largest and most bulky is the muscle in the buttock.

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Smooth Muscle


▪ Smooth muscles are commonly involved in involuntarymovements over which we have no conscious control.

▪ Smooth muscles are formed from thin layers or sheets madeup of cells and are found in the walls of the internal organs,such as the stomach, intestine, bladder and blood vessels(excluding the heart).

▪ Smooth muscles are not striated.

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Cardiac Muscle


▪ Cardiac muscles are unique in that they are striated inappearance but involuntary in action.

▪ As the name implies, cardiac muscles are found in themyocardium of the heart and largely make up the heart wall.

▪ This type of muscle contracts to force blood out of the heartinto the blood vessels and relaxes to allow the heart to fill withblood.

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Skeletal Muscle Fibers


▪ Each one of skeletal muscles is made up of hundreds tothousands of muscle fibers that are tightly wrapped togetherby connective tissue.

▪ Each muscle fiber contains smaller units made up of repeatingthick and thin filaments.

▪ This causes the muscle tissue to be striated or have a stripedappearance.

▪ Skeletal muscle fibers are classified into two types:

• Type 1o These fibers utilize oxygen to generate energy for movement.o Type 1 fibers have a higher density of energy-generating

organelles called mitochondria. This makes them dark.

• Type 2-Ao Like type 1 fibers, type 2A fibers can also use oxygen to generate

energy for movement.o However, they contain less mitochondria, making them light.

• Type 2-Bo Type 2B fibers don’t use oxygen to generate energy.o Instead, they store energy that can be used for short bursts of

movement.o They contain even less mitochondria than type 2A fibers and

appear white.

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Smooth & Cardiac Muscle Fibers


▪ Smooth muscle fibers have an oblong shape, much like afootball.

▪ They’re also thousands of times shorter than skeletal musclefibers.

▪ Cardiac muscle fibers have their own rhythm.

▪ Special cells, called pacemaker cells, generate the impulsesthat cause cardiac muscle to contract.

▪ This typically happens at a constant pace but can also speedup or slow down as necessary.

▪ Second, cardiac muscle fibers are branched andinterconnected.

▪ When the pacemaker cells generate an impulse, it spreads inan organized, wavelike pattern, which facilitates the beating ofyour heart.

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How Muscles Work?


▪ Muscle and muscles fibers work to cause movement in thebody.

▪ The first thing that occurs is something called depolarization.

▪ Depolarization is a change in electric charge.

▪ It can be initiated by a stimulatory input like a nerveimpulse or, in the case of the heart, by pacemaker cells.

▪ Depolarization leads to a complex chain reaction withinmuscle fibers.

▪ This eventually leads to a release of energy, resulting inmuscle contraction.

▪ Muscles relax when they stop receiving a stimulatory input.

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Fast and Slow Twitch


▪ Fast-twitch and slow-twitch refer to skeletal muscle fibers andrefer also to how fast muscles contract.

▪ Types 2-A and 2-B are FT while type 1 fibers are ST.

▪ The speed at which a muscle contracts is determined by howquickly it acts on ATP.

▪ ATP is a molecule that releases energy when it’s brokendown.

▪ FT fibers break down ATP twice as fast as ST fibers.

▪ Additionally, fibers that use oxygen to produce energy (ATP)fatigue at a slower rate than those that don’t.

▪ So as far as endurance is concerned, the skeletal muscleslisted from highest to lowest are:

• type 1

• type 2A

• type 2B

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Fast and Slow Twitch


▪ ST fibers are good for long lasting activities.

▪ These can include things like holding a posture and stabilizingbones and joints.

▪ They’re also used in endurance activities, suchas running, cycling, or swimming.

▪ FT fibers produce shorter, more explosive bursts of energy.

▪ Because of this, they’re good in activities involving bursts ofenergy or strength.

▪ Examples include sprinting and weightlifting.

▪ Everyone has both FT and ST muscles throughout their body.

▪ However, the overall amount of each varies greatly betweenindividuals.

▪ FT versus ST composition can also influence athletics.

▪ Endurance athletes often have more ST fibers, while athleteslike sprinters or power-lifters often have more FT fibers.

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Attachments of Skeletal Muscles


▪ Origin

• Least movable

• Mostly fleshy

• Proximal end

▪ Insertion

• Most movable

• Mostly fibrous

• Distal end

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Types of Attachments


▪ Tendons

• A tough cord of fibrous connective tissue that usuallyconnects muscle to bone and is capable ofwithstanding tension.

▪ Aponeurosis

• A thin broad and strong sheet of fibrous tissue.

▪ Raphe

• An interdigitation of the tendinous ends of the flat muscles.

• Example: mylohyoid raphe

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Directions of Muscle Fibers


▪ Parallel to line

• More range of movement, less powerful.

▪ Pennate (oblique to line)

• More powerful, less range of movement.

o Unipennate

o Bipennate

o Multipennate

▪ Fusiform

• Spindle-shaped (round, thick belly, & tapered ends).

▪ Circular

• Surround a body opening or orifice, constricting it whencontracted.

▪ Triangular

• Have a broad attachment from which the fascicles converge toa single tendon.

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Mode of Actions


▪ Prime mover (Agonist)

• It is the chief muscle responsible for a particular movement.

o Example: Biceps Brachii is the prime mover for flexion of theelbow joint and forearm.

▪ Antagonist

• It opposes the action of the prime mover.

• Before contraction of prime mover, antagonist must be relaxed.

o Example: Triceps Brachii is the antagonist for prime mover forextension of the elbow joint and forearm.

▪ Synergist

• Muscles that assist the prime mover in a particular movement.

o Example: Brachialis muscle for Biceps prime mover muscle.

▪ Fixator

• Its contraction does not produce movement by itself but itstabilizes the origin of the prime mover so that it can actefficiently.

o Example: Deltoid muscle for Biceps prime mover muscle.

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Naming of Muscles


▪ Size• Major or Maximus (large)• Minor or Minimus (small)• Latissimus (broad)• Longus (long)• Brevis (short)

▪ Position• Pectoralis (pectoral region)

▪ Depth• Superficialis (superficial)• Profundus (deep)• Externus (external)

▪ Shape:• Deltoid (triangular)• Teres (rounded)• Rectus (straight)

▪ Number of Heads:• Biceps (2 heads)• Triceps (3 heads)• Quadriceps (4 heads)

▪ Attachments:• Coracobrachialis

▪ Action:• Flexor digitorum: flexion of digits

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Contoso Ltd.


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Fibromyalgia


▪ Fibromyalgia is a term used to describe a common syndromein which people experience long-term, widespread pain andtender points in joints, muscles, tendons and other softtissues.

▪ It also results in disturbed sleep and exhaustion.

▪ The cause is unknown but possible triggers include viralinfection, physical and emotional stress.

▪ It tends to be more common in people with pre-existing lupus,rheumatoid arthritis, or ankylosing spondylitis.

▪ There is no cure but symptomatic treatment can help somepatients.

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Muscle Cramp


▪ A muscle cramp is a sudden and involuntary contraction ofone or more of your muscles.

▪ If you've ever been awakened in the night or stopped in yourtracks by a sudden charley horse, you know that musclecramps can cause severe pain.

▪ Though generally harmless, muscle cramps can make ittemporarily impossible to use the affected muscle.

▪ Long periods of exercise or physical labour, particularly in hotweather, can lead to muscle cramps.

▪ Some medications and certain medical conditions also maycause muscle cramps.

▪ Overuse of a muscle, dehydration, muscle strain or simplyholding a position for a prolonged period can cause a musclecramp.

▪ Factors that might increase your risk of muscle crampsinclude age, dehydration, pregnancy and medicalconditions. You might be at higher risk of muscle cramps ifyou have diabetes, or nerve, liver or thyroid disorders.

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MuscularDystrophy


▪ Muscular dystrophy (MD) refers to a group of hereditary diseasesthat weaken different muscle groups in various ways.

▪ A person affected with MD has a genetic mutation that prevents therepair of muscle tissue.

▪ This muscle weakening occurs gradually over time.

▪ Symptoms may start at any time from infancy through to adulthood.

▪ The most common form of muscular dystrophy is Duchenne’smuscular dystrophy (DMD).

▪ It is caused by a genetic defect, which results in the body’s failure toproduce a specific protein called dystrophin.

▪ It predominantly affects boys between the ages of 2 and 6 years.

▪ By age 10 to 12 years these children will often be in a wheelchair.

▪ This disease also affects other body systems so patients needregular respiratory and cardiac assessment.

▪ It is likely that these patients will eventually need a ventilator tobreathe.

▪ People with DMD usually do not survive beyond their late teens orearly adulthood.

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Paralysis


▪ Paralysis is the loss of muscle function in part of your body.

▪ It happens when something goes wrong with the waymessages pass between your brain and muscles.

▪ Paralysis can be complete or partial.

▪ It can occur on one or both sides of your body.

▪ It can also occur in just one area, or it can be widespread.

▪ Paralysis of the lower half of your body, including both legs, iscalled paraplegia.

▪ Paralysis of the arms and legs is quadriplegia.

▪ Most paralysis is due to strokes or injuries such as spinal cordinjury or a broken neck.

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Palsy


▪ These actually happen due to conditions affecting the nerves.

▪ These conditions can go on to affect skeletal muscles, leadingto weakness or paralysis.

▪ Examples include Bell’s palsy and Guyon canal syndrome.

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Strain


▪ A strain occurs when a muscle and/or tendon is overstretchedor torn.

▪ There is no fracture or dislocation present.

▪ Pain, weakness and muscle spasms are common symptomsexperienced after a strain occurs.

▪ Rest, application of ice and a compression bandage areeffective treatments.

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Muscle Treatments


▪ Minor muscle injuries may be treated with simple homeremedies, such as rest, applying ice, using compressionbandage, and elevating your injured limb.

▪ Anti-inflammatory medication.

▪ Physiotherapy

▪ Severe muscle injuries need to be checked by a qualifiedhealth care provider.

▪ A torn muscle or tendon may need to be surgically repaired.

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MUSCULOSKELETAL · Musculoskeletal is a general term which is deﬁnedas relating to musclesand bones of the skeleton. The musculoskeletal system comprises bones, joints, cartilage,